Haematology

Question 1

Unfractionated heparin (UFH) MOA

Answer 1

UFH enhances the activity of antithrombin, leading to the inhibition of coagulation factors IIa (thrombin) and Xa.

Question 2

Low molecular weight heparins (LMWHs) MOA

Answer 2

LMWHs exert their anticoagulant effect by targeting factor Xa

Question 3

Dabigatran MOA

Answer 3

Dabigatran is an inactive prodrug. It acts by reversibly inhibiting free thrombin, fibrin-bound thrombin, and thrombin-induced platelet aggregation.

Question 4

Apixaban, edoxaban and rivaroxaban MOA

Answer 4

These DOACs competitively inhibit both free and clot-bound factor Xa,

Question 4

DIC blood results

Platelet count
Fibrinogen
PT
D d-dimer
TT
Coag factors

Answer 4

Platelet count - low
Fibrinogen - low
PT - prolonged
D d-dimer - elevated
TT - prolonged
Coag factors - low

Question 5

INR 5-8 no bleeding

Answer 5

Withhold 1-2 doses of warfarin and reduced maintenance dose

Question 6

INR 5-8 w/ bleeding

Answer 6

IV Vit K (phytomenadione)
Stop warfarin and restart when INR <5

Question 7

INR >8 but no bleeding

Answer 7

Give oral Vit K (rpt if still high after 24hrs)
Stop warfarin and restart when INR <5

Question 8

INR >8 minor bleeding

Answer 8

Give IV Vit K (rpt if still high after 24hrs)
Stop warfarin and restart when INR <5

Question 9

Major bleeding on wafarin

Answer 9

IV Vit K & dried PT complex (or FFP if not available)
Stop warfarin

Question 10

Reversal agent for dabigatran?

Answer 10

Idaruccizumab

Question 11

What is andexanet alfa used for?

Answer 11

To reverse apixaban & rivaroxaban in pts with life threatening or uncontrolled bleeding, IF THE BLEED IS IN THE GI TRACT

Question 12

Heparin reversal agent

Answer 12

Protamine sulfate

Question 13

Which virus causes sickle cell aplastic crisis?

Answer 13

Parovirus B19

Question 14

Most common cause of osteomyelitis in children with sickle cell

Answer 14

Salmonella enterica